Government continues to implement legislation that is aimed at achieving some form of redress through the Employment Equity Act . Health MEC Dr Sibongiseni Dhlomo said that after difficulties were experienced in recruiting black candidates for these posts, a deviation was sought from the accounting officer. Dhlomo said despite the department’s best efforts, South Africa, including KwaZulu-Natal, remained an unequal society with limited opportunities for self-development for those who had been historically oppressed.
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This stance, however, did not sit well with a doctor practising in the public health sector. Speaking on condition of anonymity, the doctor said the recruitment process showed racial bias.
“The directive is blatantly discriminatory. This will impair service delivery to patients in a system already crippled by a lack of doctors. If you design admission criteria based on race alone and ignore the quality of the candidate altogether, the training programme begins to spiral and the entire system will break,” he said.
Mary de Haas, KZN violence monitor and member of the Medical Rights Advocacy Network, said representivity was important, but any selection, regardless of race, should be based on academic performance in the first degree and ideally also an indication that the candidate had aptitude in that field.
“Above-average academic performance is essential for selection to any higher degree, plus some indication of real interest in the subject and demonstrated aptitude for it. This government has had 25 years to implement non-racialism, including in medicine, and it has messed up badly because of bad education and mismanagement of health facilities,” De Haas said.
The South African Medical Association said transformation was not about addressing the demographics alone. Dr Zanele Bikitsha, the association’s KZN coastal branch chairperson, said there was a need to look at the health system as a whole, and that transformation in the sector would not be achieved overnight.
Dr Imran Keeka, DA spokesperson for health, said any attempt to redress the injustices of the past must ensure the commitment to stick to the Constitution.
“Any deviation in the form of any policy that causes the domination of one race over the other by exclusion is nothing more than an aberration of our constitutional values and is racist,” he said.
The KwaZulu-Natal Department of Health has been accused of racism over an internal directive stating that every post for registrar doctors must go to black applicants. The Witness can reveal that all 100 registrar posts across KZN hospitals for 2019 have been earmarked only for black applicants because the department has stalled on its employment equity targets. “SA is paying the price for its racist policies: law and order has collapsed, hospitals and education have collapsed — all because of race-based affirmative action.”
An internal letter addressed to the chairpersons of registrar recruitment panels stressed in no uncertain terms that posts “must be re-advertised” if there were “no suitable Africans” applying. Fully-qualified general practitioners apply to be registrars when they seek to specialise in a specific field of medicine.
These range from cardiologists, to anaesthesiologists, to surgeons. Registrar training takes four years, and doctors write exams and have to submit a thesis before qualifying.
Normally, applicants would be hired after being allocated points based on exam scores, their portfolio, and an interview process. Their racial group was considered, but the overall quality of the candidate was also a factor. KZN hospitals can accept applicants from across the country for registrar training.
There have been numerous reports in the last two years of doctors in the province suffering without jobs and posts for internships and community service. Last year, hundreds of doctors took to the streets in Durban to protest about this, and handed a memorandum to the DoH.
The directive shows a breakdown of current registrars being trained by KZN hospitals, and said there is an excess of coloured, Indian, and white registrars and a shortfall on the target for black registrars. The directive did note, however, that it would consider “requests for deviations” but said that those would have to be “convincingly motivated for” and there should be no blacks remaining in the shortlisted pool of applicants.
The directive has caused a stir among current applicants, who say they could be “stranded” for years while they wait for the KZN DoH to fulfil its transformation goals.
An annexure to the directive said that there were a total of 314 registrars, 128 of whom are black; 127 are Indian; 18 are coloured; and 41 are white.
One doctor who has been fighting the department on the lack of job posts since 2016 said he knows of two KZN-based doctors who are emigrating because of the situation. “We don’t know who to speak to about the problem. The department tells us we can apply in another province, but we have families here, we have bought houses and we can’t just uproot.”
“No one wants to speak about it because we may be seen as being racist by our peers.
“People will now have to leave KZN, yet it’s no secret that the province needs doctors.”
The KZN DoH did not respond to repeated requests for comment on the matter since Monday.
Dr Mvuyisi Mzukwa, the South African Medical Association (Sama) KZN coastal branch chairperson, said they will meet with the KZN DoH to discuss this next week, and said Sama did not support it.
“It can’t be that the department just woke up one day and noticed the status quo is like this. We need to balance the [injustices of] the past, but we can’t do it overnight. It must be implemented in phases.”
He said the directive will have a negative impact on service delivery.
The South African Minority Rights Equality Movement (Samrem), which has lobbied for doctors in the past, said such policies mirrored Apartheid ones.
“SA is paying the price for its racist policies: law and order has collapsed, hospitals and education have collapsed — all because of race-based affirmative action.”
DA spokesperson on health in the province, Dr Imran Keeka, condemned the directive, and called it racist.
“In whatever we do, we must ensure that diversity is represented. Any deviation in the form of any policy that causes the domination of one race over the other by exclusion, is nothing more than an aberration of our constitutional values and is racist,” he said.